Treatment ofproctitis, still a challenge for coloproctologists?: LTP44

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Aim:Haemorrhagicproctitis remains a challenging disorder because of its chronic and refractoryprogress in inflammatory bowel disease or after radiation. Surgical and conservative treatment options are available butprospective and randomised data are missing.Method:We retrospectively evaluated the clinical data and outcome of patients with haemorrhagicproctitis at our coloproctology unit from 2005-2008.Results:Seventy-nine patients (53 male, 26 female) with haemorrhagicproctitis were treated in our clinic. Postradiogenicproctitis was most frequently observed in 59 (75%), ulcerativeproctitis in 8 (10%) and unspecificproctitis in seven patients (9%). First-line treatment was topical administration of corticosteroids, mesalazine and mebeverinhydrochloride (with use of suppositories or clysma). Additionally sucralfat clysma was used off-label in 50% of the patients. In 13 (16.5%) patients topical application of 4% formaldehyde was used in case of refractory bleeding. No surgical complication has been observed in the mid-term follow-up.Conclusion:With the burden ofprostate carcinoma incidence of refractory radiogenicproctitis has increased in the last years. The administration of topical steroids and systemic salicylic-acid derivates as well as sucralfat clysma can be used forprimary treatment. Alternative options are topical formaldehyde in refractory haemorrhagicproctitis.

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